Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2022-12-22-67

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
QA Service Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date12/22/2022 Sample Unique Key67
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing12/22/2022
Sample typeAnnual Source Testing A brief description of the sample1 x 4 PCC Aggregate
The quantity of what the sample constitutes6 Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMark West Quarry Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-49-0032
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedMark West Quarry
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-12-22-67-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesJose Ibarra-Roman, CT D04 - Petaluma Field Laboratory12/28/2022Jose Ibarra-Roman
Yes
05/04/2023
2022-12-22-67-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Jose Ibarra-Roman, CT D04 - Petaluma Field Laboratory12/28/2022Jose Ibarra-Roman
Yes
05/04/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2022-12-22-67-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-12-22-67-2 CTM 227-December 2014 (Verified)